Doctor in Canada After MBBS: MCCQE, NAC, CaRMS and Costs

To become a doctor in Canada after MBBS from India or Europe, you pass the Medical Council of Canada Qualifying Examination (the MCCQE, formerly Part I) and the NAC Examination, match into a Canadian residency through CaRMS, and complete that residency before a provincial licence. The exams cost about CAD 5,200, roughly Rs. 3.5 lakh, in Medical Council fees alone. The hard part is not the exams. It is that nearly every province requires Canadian citizenship or permanent residence before you can even apply for residency.

Key takeaways on becoming a doctor in Canada after MBBS

• Your medical school must be listed in the World Directory of Medical Schools with a Canada Sponsor Note from the Medical Council of Canada, and your graduation year must fall inside the years the note covers.

• The MCCQE is a one-day, 230-question computer exam offered in four sessions a year at Prometric centres in Canada and more than 70 countries. The fee is CAD 1,500. The pass score is 439 on a 300 to 600 scale.

• In the Medical Council's 2025-26 year, 48 per cent of first-time international graduates passed the MCCQE, against 91 per cent of Canadian graduates.

• The NAC Examination is a 12-station clinical exam held only in Canada, twice a year, for CAD 3,320. Its first-time pass rate in 2025 was 83 per cent.

• The CaRMS R-1 match placed 931 international medical graduates in 2026, up from 851 in 2025 and 671 in 2024. Roughly half of first-iteration IMG applicants matched.

• Every province requires citizenship or permanent residence at the time of the CaRMS application. A study permit or work permit is not accepted anywhere. That makes immigration, not exams, the first step for most Indian graduates.

The route at a glance

Source for fees: Medical Council of Canada fee schedule, published 8 June 2026. Exam fees total CAD 5,202, about Rs. 3.5 lakh, before travel, the language test and CaRMS fees.

Step one: is your medical school acceptable in Canada?

The Medical Council of Canada accepts graduates of schools "listed in the World Directory of Medical Schools that is identified by a Canada Sponsor Note as acceptable in Canada". The test is simple to run. Search your school in the World Directory of Medical Schools, open the Sponsor Notes tab on the school's entry and look for a note for Canada. The Medical Council's own guidance says "a note for Canada indicates that your medical school is recognized in Canada", and its acceptable-schools page adds that your graduation date must fall within the years range in the note. The guidance is on the Medical Council page on acceptable medical schools.

Indian MBBS degrees from NMC-recognised colleges and EU Medicine degrees from state universities routinely carry the note, but check the specific school and the years, not the country. Our guide to checking NMC and WDOMS recognition shows where the Sponsor Notes tab sits.

Step two: the MCCQE, the Canadian medical licensing exam

The MCCQE was called the MCCQE Part I until 1 April 2026, and both names still appear on Medical Council pages. The Part II exam was retired, so there is now one written exam. The Medical Council's MCCQE page describes it as "230 multiple-choice questions" in two sections of 115, with "up to two hours and forty minutes for each section", taken in one day at a Prometric centre in Canada or one of more than 70 countries.

Eligibility, from the MCCQE eligibility page: you must be a graduate, or a final-year student, of an acceptable school, and your source verification request must be submitted and paid before you apply. A final-year student can apply up to 15 months before the expected graduation date with a student attestation form, which lets a European MD student or an Indian intern sit the exam before the degree is issued.

The pass score is 439 on a scale of 300 to 600, set by criterion referencing from April 2025, per the MCCQE results page. Scores from before 2025, on the old 100 to 400 scale, are not comparable.

How hard is the MCCQE for international graduates? The pass rates

This is the figure most pages leave out, and it is the one that should shape your preparation. The Medical Council of Canada annual report 2025-26 (PDF), covering 1 April 2025 to 31 March 2026, gives these first-time pass rates.

Fewer than half of international graduates pass at the first sitting, and the rate fell nine points in a year. For an Indian or European graduate, this is a USMLE-level preparation task, not a formality. Candidates who have prepared for the USMLE Step 2 CK find the clinical decision-making style familiar; our guide to the USMLE after MBBS in Europe covers the overlap.

Step three: the NAC Examination

The NAC Examination is a half-day objective structured clinical examination with "12 stations, including 2 pilot stations", 11 minutes each, in English or French, held only in Canada. The Medical Council's NAC page describes it; the NAC scheduling page gives the sessions: 19 and 20 September 2026, with results in late November 2026, and 1 May 2027, with applications from 18 November to 9 December 2026 and results in late June 2027. Centres in 2027 are Edmonton, Winnipeg, Hamilton, London, Ottawa, Toronto, Windsor and Saskatoon.

The fee is CAD 3,320, plus a flight to Canada and a visitor visa, which is why most candidates sit it only once they are serious about the match. The pass score is 577, and the first-time pass rate in 2025 was 83 per cent across 2,129 candidates, per the NAC Examination technical report 2025 (PDF). CaRMS requires international graduates to have "written and passed" both the NAC and the MCCQE before the match, with some provincial exceptions.

Step four: citizenship or permanent residence, the gate most people hit

CaRMS, the Canadian Resident Matching Service, runs the national residency match. Its R-1 match eligibility page says international graduates must "be a Canadian citizen or a permanent resident of Canada", with "some exceptions". The CaRMS citizenship summary for the 2026 match shows what those exceptions are: every province requires citizenship or permanent residence "at the time of application"; visas, permits and pending applications are accepted nowhere; refugee status is accepted in Ontario, Alberta, Quebec, Nova Scotia, New Brunswick and Prince Edward Island only.

So the sequence for an Indian graduate is immigration first, match second. The relevant routes are the Express Entry category-based draws for healthcare. The Immigration, Refugees and Citizenship Canada page on category-based selection, updated 16 October 2026, lists two relevant categories. The "healthcare and social services occupations" category needs 12 months of full-time experience in the past three years "in Canada or abroad" in a listed occupation, and the physician codes 31100, 31101 and 31102 are included. The "physicians with Canadian work experience" category needs the same 12 months, but in Canada. An Indian graduate who completes the MBBS internship and then works a year as a doctor in India can therefore enter the Express Entry pool under the first category without ever having been to Canada.

Three provinces add a provincial assessment before CaRMS: British Columbia, Alberta and Quebec. Ontario attaches a return-of-service condition to its international graduate positions. The CaRMS Ontario eligibility page puts it in capitals: applicants "are required to fulfill a ROS commitment in Ontario immediately upon completion of your training".

Step five: the CaRMS match, with the real numbers

The match is where international graduates compete for a limited pool of positions. The results for the last three years come from the CaRMS 2026 R-1 data snapshot (PDF) and the CaRMS 2025 R-1 data snapshot (PDF).

Two things stand out. The number of international graduates matched has risen by about 39 per cent in two years, from 671 to 931, as provinces open more positions. And applying in the year you graduate roughly doubles your odds compared with applying years later, because programmes weigh recent clinical exposure. Family medicine is where most of the unfilled positions sit: 139 of the 181 positions left unfilled in 2026 were in family medicine.

Residency is paid. Lengths are two years for family medicine and five years for most specialties, with sub-specialties after that. A graduate who starts residency in July 2028 after matching in March 2028 is an independent family physician in 2030 at the earliest.

Step six: the LMCC and the provincial licence

The Licentiate of the Medical Council of Canada is the national qualification that every provincial college asks for. From 26 January 2026 it is issued automatically, at no extra cost, to candidates who applied for the MCCQE on or after that date and pass, provided the degree is source-verified. Candidates who applied before 26 January 2026 pay a CAD 50 LMCC application fee. The Medical Council's LMCC page sets out both cases. The provincial licence then comes from the college of physicians of the province where you trained, after the Royal College or College of Family Physicians certification exam.

The practice-ready route: for doctors who already have specialist training

Each province runs a Practice Ready Assessment programme for international family physicians who have already completed residency abroad and been in independent practice recently. It is not a route for a fresh MBBS graduate, but it matters for an Indian doctor who finishes an MD in family medicine or general practice and then looks at Canada. The Medical Council's Therapeutics Decision-Making examination, CAD 2,850, is the gate, followed by a 12-week supervised clinical assessment and a return-of-service contract of about three years in an underserved area.

• Ontario: Practice Ready Ontario, run through Touchstone Institute, needs a TDM pass and an interview, then a 12-week assessment and a three-year return of service, per the College of Physicians and Surgeons of Ontario PRA page.

• Saskatchewan: SIPPA runs three intakes a year, with the May 2026, August 2026 and January 2027 cohorts having cut-offs of 30 January, 15 May and 25 September 2026, and from 1 June 2026 requires six months of recent practice rather than three, per the University of Saskatchewan SIPPA updates page.

Seat numbers are small and are not published for every province. Treat the practice-ready route as a specialist's door, not a graduate's.

Language requirements

The CaRMS language summary for the 2026 match lists three accepted tests for international graduates: CELPIP General with 9 in each skill, IELTS Academic with 7.0 in each skill, or OET Medicine with grade B in each skill, all from one sitting and valid until 1 July 2027 for the 2027 match. Graduates whose medical education was in English in a listed country are exempt in every province except Ontario and Quebec, and Ontario also accepts a dean's letter or a WDOMS printout showing English-medium instruction. For most Indian and European graduates, the practical answer is to sit the OET or IELTS once, well before the CaRMS deadline.

A worked timeline and budget for a 2027 graduate

The Medical Council fees alone come to CAD 5,202, about Rs. 3.5 lakh at Rs. 67 to the dollar. Add the language test, two trips to Canada for the NAC and interviews, and immigration fees on top of that. Our post on jobs after MBBS abroad compares this with the UK, US and Australian routes, and the AMC exam route to Australia is the closest parallel in structure.

What if you do not match, or do not get permanent residence

Unmatched candidates can enter the second iteration in the same year, which added 131 international graduate matches in 2026, and can reapply the following year, although the prior-year match rate of 48 per cent shows the cost of waiting. A candidate without permanent residence cannot apply at all, so the fallback is to keep practising in India or Europe, build the 12 months of experience the Express Entry category needs, and treat the MCCQE result as valid groundwork. Graduates of European universities have a second option that does not depend on immigration first: specialist training inside the EU, which we set out in our guide to medical internship and training in Europe after MBBS.

Sources

• Medical Council of Canada, fee schedule, published 8 June 2 026

• Medical Council of Canada, MCCQE Part I overview

• Medical Council of Canada, MCCQE eligibility and application

• Medical Council of Canada, MCCQE scheduling and 2026-2027 session dates

• Medical Council of Canada, MCCQE results and pass score

• Medical Council of Canada, NAC Examination and NAC scheduling

• Medical Council of Canada, NAC Examination annual technical report 2025 (PDF)

• Medical Council of Canada, LMCC

• Medical Council of Canada, acceptable medical schools and degrees

• Medical Council of Canada, annual report 2025-26 (PDF)

• CaRMS, R-1 main residency match eligibility criteria, citizenship requirements summary, language proficiency summary and Ontario criteria

• CaRMS, 2026 R-1 match data snapshot (PDF) and 2025 R-1 match data snapshot (PDF)

• Immigration, Refugees and Citizenship Canada, Express Entry category-based selection, updated 16 October 2026

• College of Physicians and Surgeons of Ontario, Practice Ready Assessment programme

• University of Saskatchewan, SIPPA important updates

• Bank of Canada, daily exchange rates, 21 October 2026